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The History of Health Education in New ZealandAround the time of the 1918 flu epidemic, the focii for health education were: - hygiene - exercise - fresh air - good foodThis indicates the responsive and situated nature of health education in relation to thesocial, economic and political context (Rice, G. cited in lecture, Sullivan). The notiontherefore, of what health education is, has evolved greatly over the last 100 years.Something that came from yesteryear and was also strong in the 1960s and 70s, was thepolitical-economic perception of the medical and health-care professions (Colquhoun,1992). Research in this area would focus on the perceived ‘virtuous’ nature of medicalprofessionals and the inequitable access to these professionals. This tied in to the idea ofhealthism (Crawford, 1980 in Tasker, 2004). Here, the emphasis for health education layon the individual’s personal responsibility. But, if some individuals did not have access tothe services with which they were supposed to gain their health, how were they meant toexercise this responsibility? The socio-ecological framework argued to provide a contextfor the ‘science of the individual’ (Lawson, 1992).During the 1980’s, the notion of health as a multi-dimensional construct emerged. Thiswas reflected in the 1985 revision of the New Zealand Health Education syllabus wherehealth was now referred to as ‘well-being’, the sum of mental, spiritual and physicalfactors (Tasker, 2004:204). This was supported by the World Health Organisation’s(WHO) Ottawa Charter, which recognised the link between environment and health,acting as a catalyst for further curriculum development and thinking in New Zealand,where the first Health and Physical Education curriculum document was drafted as aseparate curriculum area in 1995 and sent out for consultation early 1996 (Tasker, 2004).This was an official curriculum document that supported and acknowledged Mäoriconceptualisations of health, which encompassed individual and community, a holisticand relational view.
More recently, the Bangkok Charter, 2005 has raised the question of globalisation and itsrelation to health – to what extent do we need to be concerned with the internationalscene as we consider health and health education (cited in lecture, 2008)?The Concepts 1. Hauora translates literally as the breath of life or well-being. There are many models that represent and interpret the holistic and multidimensional nature of Mäori conceptualisations of health, among which is Mason Durie’s whare tapawhä (1998:69). This model represents health as consisting of four walls. If one wall falls, then the house will no longer be ‘healthy’. Te taha hinengaro, or the mental and emotional, depends on Te taha tinana, the physical, which in turn depends on Te taha wairua, the spiritual (whether this is a religious sense or as a connection to the environment) and these depend on Te taha whänau, or the social - the family. 2. The socio-ecological framework has its basis in critical thinking. What are the social, political, legislatory, environmental and tikanga-based factors that affect hauora? What are the obstacles to well-being and how can they be removed or overcome? This approach encourages active contribution to both personal well- being and the well-being of others through critique of: a. power and privilege b. social structures c. underlying motivations d. conflicting interests (http://www.tki.org.nz/r/hpe/index_e.php) 3. The 1986 Ottawa charter acted as the catalyst for the Health Promotion movement, which has a five pronged approach: a. Good health policy b. Up skilling individuals c. Providing and/or realigning health services d. Encouraging community action e. Promoting a healthy environment.
4. Attitudes and values functions on many levels: promoting “a positive and responsible attitude” (NZC, 1999:34) to self; a respect for others; a care for community and environment; and “a sense of social justice” (ibid.).These concepts are interlinked and, together provide a multidimensional picture of thepotential for health education in New Zealand.The extent of topicsThe Health and Physical Education curriculum consists of four strands: - Personal Health and Physical Development - Movement Concepts and Motor Skills (specifically P.E.) - Relationships with Other People - Healthy Communities and EnvironmentsThe 1999 curriculum expands on these areas by specifying seven other topic areas, whichare: • -Mental health • Sexuality education • Food and Nutrition • Body Care and Physical Safety • Physical Activity • Sport Studies • Outdoor EducationWhile the latter three topic areas could be seen as purely P.E. based, I argue that someforms of outdoor education are health-based. For example, a survival unit delivered atNewton Central when I was a kaiäwhina there taught the children the practical skills theywould need to keep themselves safe in the event of a natural disaster. There was aproblem-solving approach as the children figured out how to design and build a shelter;how to catch, filter, purify and store water; how to gather, prepare and store food; how todesign and implement a hygienic sanitation system and how to make bedding fromnaturally available resources.
Overall, these strands and topic areas give us an incredibly wide range of topics to choosefrom. We could teach and learn anything in our classrooms, from: stereotyping anddiscrimination; substance abuse – the what’s and why’s; suicide, death, grief and loss;choices, opportunities and obstacles to healthy eating and healthy living; self-worth andresilience. While some of these topics are perceived as hard topics of potential risk toteachers as professionals, I believe that with open communication to families and thewider community, none of these topics need to be left in the ‘too-hard’ basket. There hasto be a balance in the delivery of any of these topics. You cannot speak only the ‘bads’when doing a unit on substance abuse. There are always reasons for using the substances.There are always positives. Children know when you are being deliberately biased and Iknow that when I was young, I would quickly move to do something if I was told Iwasn’t allowed to do it. Why not share the positives with the negatives and debate as aclass on which outweighs the other? Why not raise awareness so that when children getgiven the choice they can make an informed decision? I believe that if this is explainedand justified to parents, then there can be more openness within the health curriculum. Ifthere are parents who choose to withdraw the class from these units, make sure there ismore ‘conventional’ related work for the students to work through and consider. If wewant to build the critical thinkers of tomorrow, then we need to be willing to take risks.Key CompetenciesThe five key competencies identified in the New Zealand curriculum were informed byinternational research to find out the essential skills required by people to be active andsuccessful members of their communities. Rychen and Salganik argue that thesecompetencies must be: • universally relevant • holistic • authentic and demonstratable (2003, in Boyd & Watson, 2006:2).The key competencies that are in the New Zealand curriculum include: • thinking and moving
• using language, symbols and text • managing self in... • relat[ion] to others • participating and contributing (italics indicate my changes from the original)They are the result of dialogue between Ministry staff, researchers and practitioners.They are more than just skills and attitudes, but function in an integrated way across allareas of learning (Hipkins, Boyd & Joyce, 2005:5). There is much debate about each ofthe above and, in fact, about exactly what a competency is or should be defined as. Ibelieve that key to integrating the above into the health curriculum is your interpretationof the competencies. I agree with those who debate the separation of thinking andmoving. The two are inseparable. I would also combine the third and fourth, as to me, theconcept of self is the result of relating to others. I experienced the introduction of theproposed draft curriculum into the classroom by Whaea Tamsin, who explored thecontents with the children and then debated what they had just explored. What wasimportant? What was not so important? Had anything important been left out? The classthen drafted feedback sharing their thoughts with the Ministry of Education. I believe thisis an example of all of the key competencies in action. When incorporating thecompetencies into the health curriculum, we need to acknowledge the link betweenthought and action – the movement from using language, symbols and text, thinkingabout it, relating to others as you think about it and then participating and contributing asyou move to take action. Another example: AIDS awareness. To take action, the childrencould participate and contribute as part of online communities, such aswww.takingitglobal.org and share their learning in a forum, communicate it through filmor collaborate with an international group to find avenues for taking action.Values“Kind of obscure, it’s got a lot of vague things, values and things like that”, was a teachercomment from Sullivan’s research into perceptions of health education (2003:142).Values are inherently subjective. While the values are outlined in the curriculumdocument, and teachers and schools are told that these ‘deeply held beliefs’ are ‘to be
encouraged, modelled and explored’ (NZC, 2007:10), who is to say how these values areinterpreted in relation to the health curriculum? How are they to be modelled in theclassroom and what does it mean to be curious? When one teacher encourages children toask questions and the next sends children to the principal’s office for questioning, howare we to ensure that there is some form of constancy? At face value, these values thatshould be integrated across all curriculum areas are commendable, consisting of: - excellence - innovation, inquiry and curiosity - diversity - equity - community and participation - ecological sustainability - integrity - respectBut what does it mean to teach the valuing of diversity? Census 2001 records close to700,000 New Zealanders born overseas, with a range of languages spoken in this countrythat covers the globe (www.statistics.govt.nz). I believe that language is a vehicle forculture and a tool for empowerment. Therefore, I should encourage my class to teacheach other parts of their respective languages and complement this with the integration ofte reo Mäori within a range of health topics. An example: teaching each other ways tocommunicate ‘no’, ‘stop’ or ‘I am feeling uncomfortable’ as part of a Keeping OurselvesSafe unit. I should also encourage ESOL or NESB students to use their native tongue forcommunication as they become familiar with English. But is this enough? What else doesit mean? Possibly the only way for successful planning and implementation around thecurriculum values, lies in the concept of the reflective practitioner. Through reflection,thought and deliberation, I can come to grips with exactly what the values mean to meand this will hopefully result in a depth of delivery. And, as the curriculum documentsuggests, dialogue will help in the process of articulating exactly what these values meanto me in the classroom, to the students I work with, to the school I work within and to thewider community.
ReferencesBoyd, S. and Watson, V. (2006). Shifting the frame: Exploring integration of the Key Competencies at six Normal Schools. NZCER: Wellington.Durie, M. (1998). Tirohanga Mäori: Mäori health perspectives. In Whaiora: Mäori health development. 2nd ed. Auckland, NZ: Oxford University Press (p. 66-80).Hipkins, R., Boyd, S. & Joyce, C. (2005). Documenting learning of the key competencies: What are the issues? A discussion paper. NZCER: Wellington.http://www.stats.govt.nz/tables/2001-census-cultural-diversity-tables.htm Cultural Diversity Tables. Retrieved 17/08/2008.http://www.tki.org.nz/r/hpe/index_e.php TKI Health and Physical Education Online Community. Retrieved 20/08/2008.Lawson, H. (1992). Toward a socioecological conception of health. Quest ; v.44, no.1, 1992 (p. 105-121)Ministry of Education. (n.d.). The Socio-ecological Perspective and Health Promotion in Health and Physical Education in the New Zealand Curriculum (pp 8-10).Ministry of Education. (2007). The New Zealand Curriculum: for English-medium teaching and learning in years 1-13. Wellington: Learning MediaMinistry of Education. (1998). Health and Physical Education in the New Zealand Curriculum. Wellington: Learning MediaSullivan, R. (2008). Health Education lecture series. Session 1 and session 4 cited.Sullivan, R. (2003). You wonder if it’s all worthwhile. In B. Ross and L. Burrows (Eds). It takes two feet : teaching physical education and health in Aotearoa New Zealand Palmerston North, N.Z. : Dunmore Press (p. 138-149)Tasker, G. (2004). Health education: contributing to a just society through curriculum change. In A. O’Neill, J. Clark and R. Openshaw (Eds). Reshaping culture, knowledge and learning: policy and content in the New Zealand curriculum framework. Palmerston North, N.Z: Dunmore Press (p. 203-223).